Healthcare / Co-creating for End-customers
The customer was a healthcare-claims provider who worked with hospitals, insurance firms and also patients. It thus fulfilled the role of a mediator
The customer was a healthcare-claims provider who worked with hospitals, insurance firms and also patients. It thus fulfilled the role of a mediator.
For instance, there was one system to process the claims, and another to apply for the claims. There was a third system to convert data into standardised templates such as ICD-9, ICD-10 and so on. (ICD, or the International Classification of Diseases.) The systems were siloed, which resulted in delays while on-boarding employees. This gave our client’s competitors an opportunity to take business away. After all, employers could choose from a large playing field. Domain expertise does not mean business.
To maximize sales impact, we devoted time to map out the organisation’s functional leaders. We needed the CXO leadership to build consensus across functions during our implementation.
Think about it. This enterprise caters to several multinational employers. So it requires functions like customer support, claims, and so on. We had to align these functional heads with the end-customers first. So our first goal was to create a governance model across business and product owners.
The governance model first helped in building credibility across the enterprise. And helped us define product requirements. Together, we created a landscape of solutions, starting from the employer on-boarding process, to claims data collection, processing and approval.
In the spirit of co-creation, the business heads had a veto over our automation recommendations. We heard their concerns in daily meetings, concerns based on their department’s experience under the new system.
Over six months, we designed and built independent claims-processing portals for each employer and their employees. This approach factored in the policies of different American states where the respective employer had operations.
All this began by first recognising every aspect of the claims-processing enterprise’s legacy system. With the credibility we built over months, the enterprise leaders understood why we would gradually de-commission the old systems.
We didn’t over-promise. Expectations were set for a step-by-step phased implementation. The whole transformation to the first-level digital platform has allowed the introduction of innovations like Big Data analytics, A.I. and chatbots.
Our takeaway: Make sure the leadership understands and agrees with the big picture. Take them through the what and how of the transformation. In the process, our founders elevate functional heads’ understanding to the CXO leadership’s vision.